An ICU nurse at Jersey City Medical Center provided Jersey City Times with an account of nursing work at the hospital under Covid-19. Only certain personal details have been changed to protect the staff member’s identity. Explanations of certain abbreviations have been provided.
Where the Nurse Works
“I work in the critical care division, which is both ICU and cardiac care unit. The physical units are next to each other and have blended to care for 100% COVID-19 patients with overflow going to extra space in the cardiac cath (catheritization) lab. Patients who would normally require ICU-level care but have complications that are not COVID are being kept separately in the post anesthetic care unit. All of the patients in ICU are vented (on ventilators).”
The Numbers
“A lot of the questions regarding numbers is operational and changes from day to day and isn’t really given to staff outside of those working in operations itself, so it is difficult to give a precise number of patients. Additionally the overflow is not present on the unit, but we have somewhere around 40-50 patients between the units and the overflow. There are also a tremendous number of COVID+ patients (patients who have tested positive for the coronavirus) hospital-wide as well as PUI (persons under investigation) with over 100 positives and around 80 under investigation. The hospital website says there are about 200 beds, so these are big numbers. We have obviously created more beds during this surge, but there appears to be 20-30 patients admitted to the hospital but being held in the ED (emergency department) due to lack of beds at any given time.”
A Shortage of Personal Protective Equipment
“PPE situation has changed day over day. As the ICU and CCU ran out of negative pressure rooms, patients had to be placed in regular rooms with curtains, so the whole unit is exposed to the aerosolized virus due to the ventilators. We are given one N95 mask per day and expected to use it for the entirety of the shift. They have started collecting the masks for sterilization and reprocessing (back to the employee who used it) in case the shortage continues further. We have run short on gowns at times and were expected to reuse them. We are very short on sanitizing wipes, and generally any cleaning supplies provided are not the ones we are used to having.”
The Facility is Stretched
“Due to the lack of negative pressure rooms, the rooms with curtains have HEPA filters which are industrial sized and extremely loud. The sound of them all going on the unit is deafening, and it makes it hard to communicate to other staff or sometimes even hear the alarms of an IV pump or a ventilator. It’s hard to hear anything at all.”
The Staff is Stretched
“Staff is definitely short. They have pulled nurses from other areas that are now closed like endoscopy or interventional radiology to help with ‘team nursing’ so where we would normally be at a 2:1 ratio, we may be assigned to 4 patients but have another nurse who may not have a critical care background on the unit to help with other nursing tasks. Some nurses from other areas have previously worked in critical care and have returned to the bedside to take a full patient assignment. We are being told we have 13 critical care nurses out with symptoms, so that definitely strains staffing. Other departments have felt the effects as well with large surges in staff and doctors getting sick.”
Available Treatment
“The treatments we are using are the hydroxychloroquine and azithromycin. Evidence on any treatments across the board is limited, so it feels like this is all we have. From ICU, we have yet to really see many people get better.”
The Numbers Going Forward
“The big surge of patients hit us over the last weekend and has continued for the week. New Jersey is predicting that this week and next week will be our worst, and so far that has been true at the hospital. Most patients seem to get worse before they improve, so we tend to see patients who have been admitted to the regular medical floor then decline, get intubated, and then come to ICU.”
Nurses’ Safety
“At home I follow regular measures to protect myself and my family but nothing drastic. It is not realistic for us to stay separate for this time, and it is likely I have already been exposed given how many nurses on the unit tested positive before we were even universally wearing masks. My scrubs go straight in the wash and I wipe down my phone and things in my pockets, my shoes have always stayed outside. I avoid all errands and send family members in a mask and with hand sanitizer if we really need something (I still need fresh food for work!)”
Support From Hospital Administration
“I think the difference between myself and other coworkers is that l genuinely think the hospital is doing their best. Some people feel frustrated by the admin and feel they (staff) are not being protected. But we are in a global health crisis, and that is the reality of it. If admin could give us what we need, they would have done it. They brought in vents we have never seen before because they got them from somewhere, and they are doing that for PPE when they can. The situation is not ideal, and it’s important that other nurses have spoken out because that gets us things like donations. Nurses mostly have voiced that they haven’t been compensated fairly considering it is a hazardous environment.”
All photos Jersey City Times